A586 – Repeat consultation
OHIP General Listings Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A repeat consultation is an additional consultation rendered by the same consultant, in respect of the same presenting problem, following care rendered to the patient by another physician in the interval following the initial consultation but preceding the repeat consultation.
When to Use
- Bill A586 when a patient's primary care physician refers them to a specialist, the specialist sees the patient (initial consultation), another physician then sees the patient for the same issue, and the original specialist then sees the patient again for the same issue based on a new referral.
- Use A586 if a patient sees a specialist for a complex condition, is subsequently managed by another physician for that same condition, and requires a follow-up opinion from the original specialist for the same presenting problem, supported by a new referral.
- A586 is appropriate when a patient's condition requires input from a specific consultant, they receive care from another physician after the initial consultation, and a subsequent consultation by the same original consultant is needed for the same problem, with a new request.
Common Pitfalls
- Billing A586 when the patient has not been seen by another physician in the interval between consultations; this scenario would likely be an A007 (Follow-up visit) or similar, not a repeat consultation.
- Failing to obtain a new written request for the repeat consultation; the original request is insufficient for A586.
- Billing A586 when the subsequent consultation is for a new presenting problem, rather than the same problem addressed in the initial consultation.
Billing Tips
- Ensure the documentation clearly states that another physician provided care for the same presenting problem between the initial and repeat consultations.
- Verify that the new written request for A586 explicitly names the consultant and specifies the service required, mirroring the requirements for an initial consultation.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Consultation
Consultation
Must be rendered following a written request from a referring physician, nurse practitioner, or dental surgeon (for hospital-based dental procedures).
The consultant must be the same physician who rendered the initial consultation.
The service must be for the same presenting problem as the initial consultation.
Another physician must have rendered care to the patient in the interval between the initial consultation and the repeat consultation.
Requires a new written request for the repeat consultation.
The consultant must perform a general, specific, or medical specific assessment, including a review of all relevant data.
A written report (findings, opinions, and recommendations) must be provided to the referring provider.
A copy of the written request for the consultation, signed by the referring physician, nurse practitioner or dental surgeon must be kept in the consulting physician’s medical record, except in the case of a consultation which occurs in a hospital, long-term care institution or multi-specialty clinic where common medical records are maintained.
The request identifies the consultant by name and/or the specialty being consulted, the referring physician, nurse practitioner or dental surgeon by name and billing number, and identifies the patient by name and health number.
The written request sets out the information relevant to the referral and specifies the service(s) required.
A586A is designated for 'Video Only' virtual care services.
The written request must identify the consultant, the referrer, and the patient, and specify the service required.
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